Abstract
In light of the 2016 summer Olympic games it is anticipated that Canadian practitioners will require information about common illnesses that may affect travellers returning from Brazil. To identify the demographic and travel correlates of illness among recent Canadian travellers and migrants from Brazil attending a network of travel health clinics across Canada. Data was analyzed on returned Canadian travellers and migrants presenting to a CanTravNet site for care of an illness between June 2013 and June 2016. During the study period, 7,707 ill travellers and migrants presented to a CanTravNet site and 89 (0.01%) acquired their illness in Brazil. Tourists were most well represented (n=45, 50.6%), followed by those travelling to "visit friends and relatives" (n=14, 15.7%). The median age was 37 years (range <1-78 years), 49 travellers were men (55.1%) and 40 were women (44.9%). Of the 40 women, 26 (65%) were of childbearing age. Nine percent (n=8) of travellers were diagnosed with arboviruses including dengue (n=6), chikungunya (n=1) and Zika virus (n=1), while another 14.6% (n=13) presented for care of non-specific viral syndrome (n=7), non-specific febrile illness (n=1), peripheral neuropathy (n=1) and non-specific rash (n=4), which are four syndromes that may be indicative of Zika virus infection. Ill returned travellers to Brazil were more likely to present for care of arboviral or Zika-like illness than other ill returned travellers to South America (23.6 per 100 travellers versus 10.5 per 100 travellers, respectively [p=0.0024]). An epidemiologic approach to illness among returned Canadian travellers to Brazil can inform Canadian practitioners encountering both prospective and returned travellers to the Olympic games. Analysis showed that vector-borne illnesses such as dengue are common and even in this small group of travellers, both chikungunya and Zika virus were represented. It is extremely important to educate travellers about mosquito-avoidance measures in advance of travel to Brazil.
Highlights
During the past three years, Zika virus and chikungunya have emerged in the Americas [1,2,3] and dengue continues to be transmitted at high rates throughout the Caribbean, Central America and South America [4]
7,707 ill travellers and migrants presented to a CanTravNet site and of those, 89 (0.01%) acquired their illness in Brazil
CanTravNet surveillance data can be used to better inform health professionals preparing prospective travellers to Brazil and the post-travel diagnostic approach to ill travellers and migrants returning to Canada from Brazil
Summary
During the past three years, Zika virus and chikungunya have emerged in the Americas [1,2,3] and dengue continues to be transmitted at high rates throughout the Caribbean, Central America and South America [4]. High rates of Zika virus in the Pernambuco state of Brazil heralded the recognition of a devastating new congenital neurologic syndrome [6]. In order to fill this knowledge gap, the authors conducted a Canada-specific traveller-level surveillance summary of illness among returned Canadian travellers and migrants to Brazil who presented for care at CanTravNet sites over a three-year period. In light of the 2016 summer Olympic games it is anticipated that Canadian practitioners will require information about common illnesses that may affect travellers returning from Brazil
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